FORM 1023-EZ for HOLDEN TWENTY TWO MINERS MEMORIAL FUND INC

Field Data
EIN 47-3849894
Case Number EO-2016103-000112
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOLDEN TWENTY TWO MINERS MEMORIAL FUND INC
Organization’s Mailing Address PO BOX22
City HOLDEN
State WV
ZIP 25625
Accounting period End 12
Primary contact name EUGENE RUSSELL EA 73752
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ISOM OOTEN
PRESIDENT
83 PRIVATE DRIVE 15455
CROWN CITY NY 45623

Officer/Director/Trustee Two

PATRICIA SAZY
FIRST VICE PRESIDENT
2401 SILVERBROOK AVENUE
LOUISVILLE KY 40220

Officer/Director/Trustee Three

CONNIE PREECE
2ND VICE PRRSIDENT
PO BOX 244
OMAR WV 25638

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/28/2015
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Y50 - Cemeteries, Burial Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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